<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">
<html>
	<head>
	<title>Andrick Service SRL</title>
	<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1;charset=utf-8">
	<meta http-equiv="Script-Content-Type" content="text/javascript; charset=iso-8859-1">
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	<meta name="description" content="Andrick Service SRL">
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        <link rel="stylesheet" href="styles/virtes.css" type="text/css" />
	<script charset="iso-8859-1" src="js/dom.js" type="text/javascript"></script>
	<script charset="iso-8859-1" src="js/ajax.js" type="text/javascript"></script>
	<script charset="iso-8859-1" src="js/extra.js" type="text/javascript"></script>
	<style>
.tabla_encuesta
{
        background-color: #ece5b6;
        border: 1px solid #000000;
        margin-left: auto;
        margin-right: auto;
        width: 645px;
}
</style>
	</head>
	<body>
        <div id="menuzone"></div>
        <div id="workzone">
		        <form id="formGeneral">
                		<table border="0" cellpading="0" cellspacing="0" class="tabla_encuesta">
	                        <tr>
        	                        <td class="titulo_box_flotante">
	                                        <span>DATOS GENERALES</span>
	                                </td>
        	                        <td class="cerrar_box_flotante">
                	                        <img src="plantilla/cross.gif">
                        	        </td>
	                        </tr>
                                <tr>
                                        <td colspan='2' class='txt_simple'>
                                                Documento de identidad
                                                <br />
                                                <input name='inputForm' size='8' class='text_box' maxLength='8' id='campoFoco'>
                                        </td>
                                </tr>
	                        <tr>
                	                <td colspan='2' class='txt_simple'>
        	                                Nombres
                        	                <br />
	                                        <input name='inputForm' size='30' class='text_box' maxLength='30'>
	                                </td>
	                        </tr>
	                        <tr>
	                                <td colspan='2' class='txt_simple'>
	                                        Apellidos
	                                        <br />
	                                        <input name='inputForm' size='30' class='text_box' maxLength='50'>
	                                </td>
	                        </tr>
	                        <tr>
        	                        <td colspan='2' class='txt_simple'>
	                                        Organizaci&oacute;n
	                                        <br />
	                                        <input name='inputForm' size='30' class='text_box' maxLength='50'>
        	                        </td>
	                        </tr>
	                        <tr>
	                                <td colspan='2' class='txt_simple'>
	                                        E-mail
	                                        <br />
	                                        <input name='inputForm' size='30' class='text_box' maxLength='50'>
	                                        <br />
	                                        <br />
	                                </td>
        	                </tr>
        	                <tr>
                                       <td colspan='2' class="titulo_box_flotante">
                                                <span>DATOS DE AUTENTICACI&Oacute;N</span>
                                        </td>
        	                </tr>
	                        <tr>
	                                <td colspan='2' class='txt_simple'>
	                                        Usuario
	                                        <br />
	                                        <input name='inputForm' size='7' class='text_box' maxLength='4'>
	                                </td>
	                        </tr>
	                        <tr>
	                                <td colspan='2' class='txt_simple'>
	                                        Password
	                                        <br />
	                                        <input type='password' name='inputForm' size='15' class='text_box' maxLength='15'>
	                                </td>
	                        </tr>
                                <tr>
                                        <td colspan='2' class='txt_simple'>
                                                Reingreso de password
                                                <br />
                                                <input type='password' name='inputForm' size='15' class='text_box' maxLength='15'>
                                        </td>
                                </tr>
	                        <tr>
	                                <td align='center'>
	                                        <br /><input type="button" value="Guardar" class="boton_enviar">
	                                              <input type="button" value="Cancelar" class="boton_enviar">
	                                </td>
	                        </tr>
	                </table>
        	</form>
        </div>
        <div id="boxzone"></div>
        <div id="extzone"></div>
	</body>
</html>
